Half of the new jobs gained by women in January were in low-wage industries, according to an analysis by the National Women’s Law Center (NWLC).

The January jobs report was encouraging overall, with 257,000 new jobs added. Even if job growth continues at this rate, however, it will take until May 2017 for the labor market to get back to the pre-recession health it enjoyed in 2007.

Of those 257,000 new jobs, 39 percent, or 101,000, went to women. About half of those jobs were in the low-wage sectors of retail and leisure and hospitality.

That’s a bit worse for women than 2014 overall, when women gained about 45 percent of new jobs and 27 percent of those were in retail or hospitality.

Just one-fifth of men’s job gains last month, and one-third of job gains overall, were in those same low-wage sectors.

Women make up a disproportionate number—two-thirds—of low-wage workers. Women working as home health aides, fast food workers, maids, and other low-wage jobs tend to lack access to benefits, like paid sick leave or child care, that they need to take care of their families.

“The economy is moving in the right direction, but we need to step on the gas—not ease off,” said Joan Entmacher, NWLC’s vice president for family economic security. “Half of women’s job gains last month were in low-wage sectors that don’t pay enough to support a family.”

This piece is published in collaboration with Echoing Ida, a Forward Together project.

When Brittany Mostiller shared her abortion story in November as part of a 1 in 3 Campaign abortion speak-out, she talked about how the economic challenges she was facing informed her decision to have an abortion. Mostiller was 23 years old and working part-time at a grocery store to support her three daughters, all under age 7. She was having a hard time paying rent and feeding her family, and the thought of another pregnancy brought on thoughts of suicide.

Even though an abortion was the right choice for her, barriers like the Hyde Amendment, which bans Medicaid recipients from using their health insurance to cover an abortion procedure, were in her way. She eventually was able to receive financial assistance from her local abortion fund and have an abortion, but her financial situation and insurance provider shouldn’t have prevented her from accessing health care on her own.

Abortion stories like Mostiller’s dominated the media last year. But too often, the circumstances that led women to have an abortion were under-discussed; the fact that they had an abortion at all became the focal point. As Anu Kumar points out in a recent piece for RH Reality Check, this has the negative effect of putting the weight on the individual story and not on the collective action we can all take to remove systemic barriers to health care and other services benefiting low-income women and single mothers. As more of us move to share our stories in 2015, advocates should not only promote these stories as they work to reduce stigma around abortion, but also push for policy reforms that match the full spectrum of needs laid bare in these stories.

Last year, we saw people speak out about what went into their decision to choose an abortion, which has helped create a more complete picture of why 30 percent of women choose to have one by age 45. Lucy Flores, a Nevada State Assembly member, shared her story about not having access to comprehensive sexual health education in her community. Texas state Sen. Wendy Davis said her abortion decisions were based on the health of her pregnancies. We also heard from rapper Nicki Minaj, the CEO of Planned Parenthood, a writer at Salon, 26 women in New York magazine, the features director and four women at Elle, four couples in Cosmopolitan, eight women in Glamour, the young woman who filmed her abortion, and over 100 people, including myself, during the 1 in 3 Campaign’s eight-hour online speak-out. People even shared their stories at the front doors of strangers’ homes.

Many said they told their stories to highlight a different narrative about abortion, the people who have them, and what goes into the decision.

“I share my abortion experience because my lived experience is that of so many other women, particularly marginalized women,” Brittany Mostiller told me via email in December. “However, women on the margins have always been at the center of the reproductive health chopping block. We need policy change and we have to be a part of that process.”

Mostiller is now the executive director of the Chicago Abortion Fund, helping make sure other people can pay for their abortions. Her experience has come full circle; she went from being without the funds, and insurance coverage, needed to get an abortion to helping people get the money they need for their abortions. What we can learn from Mostiller and other storytellers is how to have a bias toward action: Take the lessons from their stories and turn them into political actions for pro-women policies.

When our friends speak about their abortions, we should listen to truly hear what they are sharing with us. Often, buried in each story is a heart-wrenching experience of economic injustice, discrimination, and oppression. When storytellers share their whole story, then, they’re able to tell us the role low wages, jobs without health insurance, racism, gender discrimination, and lack of access to food and child care may have played in their abortion experience. Not only will we gain a clearer sense of what many women are forced to endure, but by sharing their stories, and our own, we can help to eliminate stigma on an individual level while effecting change on a cultural and policy level.

As Anu Kumar explains, we need more than just stories to affect policy change and reduce stigma. “Certainly, sharing stories can be a powerful act and may reduce self-shaming. But are we making women alone responsible for stigma reduction?” she asks. “I fear that it distracts from the structural inequalities of race, poverty, age, and education by placing too much emphasis on the individual. And I worry that it lets our politicians and policymakers off the hook.”

She’s right—stories are important, and they must be connected to the larger issues affecting our everyday health experiences just as lawmakers must be held accountable.

As such, for families like Mostiller’s, we must renew the fight to repeal the Hyde Amendment. And for poor families across the country, we must repeal family cap laws, which refuse additional government aid for poor families who have children while on public assistance, and do nothing but stigmatize, keep poor families in poverty, and punish children because their families are poor. Families in poverty need support and compassion, not judgment and shame. The abortion stories that describe trying to make ends meet as a low-income parent should remind us of that, and serve as a catalyst for policies that ensure everyone has the economic stability necessary to raise healthy families.

If we looked back at other stories shared in 2014, we could come up with a host of other needed policy reforms. For example, Rep. Flores’ story elevates the issue of whether the nation’s students are receiving accurate, non-stigmatizing sexual health education so they can make informed decisions about their bodies. Texas Rep. Dawnna Dukes’ admission that she did not experience mental health issues after her abortion reminds us that pervasive myths about abortion are still, unfortunately, informing our policy. And the many Texas abortion stories about traveling hundreds of miles, skipping meals, and not having the ability to take time off of work tell us the fight to end economic and geographic barriers to health care is far from over, especially as lawmakers are working harder than ever to close clinics.

Abortion stories give us a glimpse into the lives behind the statistics and policies. But as advocates, it’s our job to put faces on the data and show the deep impact our policies have on abortion experiences—policies that everyone can take part in shifting. This year, let’s pledge to really hear these stories, and take action so that our truths and community needs are not lost in political rhetoric and stigma. Listening to a story is only the first step. The next step—doing something—is up to us.

The agenda is “a powerful platform for us to really organize ourselves, to speak on our own behalf, and to be at the table when decisions are being made about us,” said La’Tasha Mayes, founder and executive director at New Voices Pittsburgh.

One major focus for the initiative will be to start educating members of the Black Congressional Caucus, especially the new ones, about polling data showing strong support for reproductive justice issues in Black communities, Marcela Howell, strategic director of In Our Own Voice, told RH Reality Check.

The agenda is “a powerful platform for us to really organize ourselves, to speak on our own behalf, and to be at the table when decisions are being made about us,” said La’Tasha Mayes, founder and executive director at New Voices Pittsburgh.

Mayes noted that Black women in Pittsburgh have the life expectancy of women living in developing countries like Honduras or Jamaica. “We serve Black women and girls who are under siege every day, and it’s a miracle that we survive and, in many ways, that we thrive.”

New Voices Pittsburgh also made 30,000 contacts with Black women voters, a powerful voting bloc, in the last election cycle, Mayes said.

Reproductive justice, organizers noted, is the belief that all women have the right to have children, the right not to have children, and the right to parent the children they have in a safe and healthy environment. It goes beyond a privacy-based “pro-choice” narrative that often doesn’t apply to women of color whose choices are limited by economic insecurity or lack of access to health services.

Black Women for Wellness Executive Director Janette Robinson Flint said that when the news of what happened in Ferguson, Missouri, broke, she was sitting in a room of Black women who between them had nine sons. “It really made us think,” she said. “To have a child as a Black woman in the United States of America…is a very courageous act.”

Also courageous, and necessary, is organizing for abortion rights in the South, said Heidi Williamson, board chair of SPARK Reproductive Justice Now.

“The South is seen as the heart of darkness. People think there’s nothing that can be done,” Williamson said. But while success there may not always translate to more progressive legislation, she said, the region can spark powerful movements that come from great struggle. SPARK is working to help LGBTQ youth develop their storytelling and media skills, and they canvas door-to-door to talk to voters about personal health care and abortion stories, changing minds one person at a time.

Dr. Willie Parker, a physician who provides abortions in Alabama, Georgia, and the last abortion clinic in Mississippi, spoke about the need for solidarity with Black women and says that he is his “sister’s keeper.”

The kind of advocacy that In Our Own Voice will do is just as important as the access to abortion services he provides women, Parker told RH Reality Check.

“Creating an explicit constituency of Black women raising their voice to try to shape the policies that govern their lives is the complementary piece to my making the decision to move home to the South and provide those services for those women,” he said.

Rev. Dr. Alethea Smith-Withers of the Religious Coalition for Reproductive Choice spoke of being “prayerfully committed to reproductive justice.”

That goes for healthy sexuality in general as well as abortion or contraception, Smith-Withers said. “We’re committed to breaking the silence around sexuality and spirituality. They are not separate. They are all one.”

A poll commissioned by the initiative shows overwhelming support in the Black community, across ideological and generational divides, for not just abortion rights but also comprehensive sex education and access to contraception.

And about eight in ten said that abortion should remain legal and available in their communities, regardless of their personal feelings about it—a key difference from many “short-sighted” national polls that simply ask Americans whether they identify as “pro-life” or pro-choice, said Dazon Dixon Diallo, executive director of SisterLove, Inc.

Information like this helps combat “SSD—shame, stigma, and discrimination,” Diallo said, by showing the world what Black communities actually think about these issues.

Two women’s health groups along with a state resident on Tuesday filed a class action lawsuit against the Pennsylvania Department of Human Services, alleging that the department systematically delayed enrolling 85,000 low-income women for comprehensive health coverage.

Two women’s health groups along with a state resident on Tuesday filed a class action lawsuit against the Pennsylvania Department of Human Services (DHS), alleging that the department systematically delayed enrolling low-income women for comprehensive health coverage.

Those thousands of women currently receive limited health coverage through SelectPlan, a public program that covers only family planning care for low-income women, most of whom did not previously qualify for Medicaid. Pennsylvania administers 14 other limited Medicaid programs for low-income people who, like the women in SelectPlan, didn’t qualify for full coverage. Those programs include one called General Assistance, which covers very low-income individuals who have short-term disabilities, are survivors of domestic violence, or are in treatment programs for drug and alcohol abuse.

Last year the state expanded the eligibility criteria for Medicaid, allowing anyone with an income up to 138 percent of the federal poverty level to qualify starting January 1, 2015. Thousands of the Pennsylvanians receiving limited Medicaid coverage before the new year now qualify for comprehensive coverage through the expansion.

Due to the expanded eligibility criteria, the DHS automatically transferred people receiving limited coverage, except the women in SelectPlan, into full coverage Medicaid. But instead of the automatic and timely transfer into comprehensive coverage that the other groups received, the DHS decided to have caseworkers manually review each woman’s case file over a period of several months.

The beneficiaries of SelectPlan were the only group not automatically given full coverage by the DHS. SelectPlan was originally set to expire completely at the end of 2014, but local advocates were able to get the expiration of the program pushed back until the end of June 2015.

Still, the delay could leave thousands of women in a health-care gap, according to the suit. The women in SelectPlan who qualify for Medicaid will be without comprehensive coverage for the several months during which their applications are being reviewed. And the women whose incomes are still too high to qualify them for Medicaid might be out of coverage altogether after February 15, the last day of open enrollment for private insurance.

“DHS never told these women they would qualify for full health coverage starting January 1, and they never mentioned the February 15 open enrollment deadline,” Women’s Law Project staff attorney Susan Frietsche, who is helping represent the plaintiffs in the suit, said in a statement. “Instead, DHS told them it was evaluating what coverage to offer them and if they want timelier help, they should call the Helpline or fill out another application.”

About 70,000 women currently on SelectPlan are now eligible for coverage under Medicaid, according to the suit. The remaining 15,000 would be eligible for private health insurance.

The suit, filed by Planned Parenthood of Southeastern Pennsylvania and New Voices Pittsburgh, a reproductive justice organization, alleges that women on SelectPlan are being unlawfully delayed from full coverage by the DHS. Under federal law, states are required to provide Medicaid “with reasonable promptness to all eligible individuals” and to “timely screen those individuals not eligible for full Medicaid and timely refer them to the Marketplace for subsidized health insurance through the Affordable Care Act without requiring a separate application,” according to the suit.

“This is discrimination against low-income women and it has very real consequences for the Black women and women of color in Pennsylvania,” said La’Tasha D. Mayes, founder and executive director of New Voices Pittsburgh, in a statement. “As states surrounding Pennsylvania expanded their Medicaid program over the last year, these women were denied full Medicaid simply because of their zip code. Now that a new plan is finally in place, they are still being denied coverage, this time because they are women. This is unacceptable.”

The study examined data from the two states and found that between 3.5 and 6.5 percent of workers in those states were paid less than the state or federal minimum wage. Service industry workers were the most likely to experience wage theft, specifically in the restaurant and hotel industries.

The lost wages in those two states represent $20 million in lost income per week in New York and $29 million in lost income per week in California. Even if the number of workers that experience wage theft is only half of that in the two states studied, that means that more than two million workers across the nation are victims of wage theft.

The study also found disparities in who experienced wage theft across gender and race. Women were more likely to experience wage theft than men, and people of color were more likely to experience wage theft than whites.

One of the largest disparities was between citizens and non-citizens. While the data did not include information on the numbers of undocumented workers who experienced wage theft, the study found that in California, non-citizens were 1.6 times more likely to experience wage theft. Non-citizens in New York were 3.1 times more likely to experience wage theft.

Steven Greenhouse, labor and workplace reporter for the New York Times, told Marketplace that many of the people experiencing wage theft are undocumented. “Perhaps these numbers actually understate the problem,” Greenhouse said. “When the Census Department does its survey, it generally under-counts and under-interviews [undocumented workers].”

Greenhouse reported for the New York Times this year that more and more workers are taking employers to court, and accusing them of wage theft. David Weil, the administrator of the Department of Labor’s Wage and Hour Division, told Greenhouse that changes in business practices are driving the surge in wage theft.

“We have a change in the structure of work that is then compounded by a falling level of what is viewed as acceptable in the workplace in terms of how you treat people and how you regard the law,” Weil said.

The study concluded that wage theft is associated with increases in the number of families and individuals in poverty, increasing the amount of public assistance needed. The economic burden, in the end, is largely shifted from the private sector to the government.

An additional $15.6 million in California and $7.8 million in New York was spent on school breakfast and lunch programs due to minimum wage violations. Monthly food stamp benefits were increased by $857,900 in California and $2.8 million in New York due to minimum wage violations.

“These findings are alarming in terms of the prevalence of the problem, particularly in a set of industries where we already know workers earn low wages and struggle to earn a basic family budget,” Weil told the New York Times in response to the new study.

This is not the first study to show that wage theft is prevalent throughout the country. A study conducted in 2009 by the Center for Urban Economic Development examined data from Los Angeles, Chicago, and New York, and found that 26 percent of low-wage workers were paid less than the minimum wage in the week prior to the survey.

The study was based on data from 2011, when the minimum wage was $7.25 per hour in New York and $8 per hour in California. The minimum wage is now $8 per hour in New York and $9 per hour in California. The current federal minimum wage is $7.25 per hour.

While Congress has taken no action to raise the minimum wage, voters across the country have approved raises to the minimum wage, as the measure has continually netted across-the-board support from voters.

Low-wage and fast-food workers have been organizing labor strikes in recent months in nearly 200 cities across the country. Workers are demanding a minimum wage of $15 per hour and the right to form a union.

Walmart, for the second consecutive year, is holding a holiday food drive for its own employees. The retail giant has decided once again that instead of raising the wages of its 2.1 million employees, it will ask workers with a bit more disposable income to donate food to their associates with less.

Walmart, for the second consecutive year, is holding a holiday food drive for its own employees. The retail giant has decided once again that instead of raising the wages of its 2.1 million employees, it will ask workers with a bit more disposable income to donate food to their associates with less.

A Walmart store in Ohio gained national attention last year when it hosted a Thanksgiving food drive for workers who don’t make enough money at the store to buy food for dinners. About 825,000 hourly employees at Walmart, the country’s largest private employer, make less than $25,000 a year.

OUR Walmart, a union-backed organizing group, has estimated that most employees make less than $9 per hour.

An Oklahoma store this month is hosting a similar drive. A picture of a bin reading “Let’s succeed by donating to associates in need!!!” was posted to the Making Change Facebook page and attributed to a Walmart in the state.

The company is owned by the six members of the Walton family, who, in 2012 had a collective net worth of $90 billion, or more than the combined income of the lowest-earning 42 percent of Americans. That year, Walmart’s net sales added up to $419 billion, more than the GDP of Norway.

Walmart employees and labor justice groups have targeted the company for its low-wage jobs and lack of support for employees. Since 2012, Walmart workers and allies have organized one-day walkout protests, culminating in strikes during Black Friday, the largest retail event of the year, starting the day after Thanksgiving.

Democrats in the U.S. Committee on Education and the Workforce concluded in a 2013 study that Walmart’s low wages and benefits force its employees to turn to government aid and cost taxpayers between $900,000 and $1.75 million per store, every year.

Speaking out for better working conditions comes with a price; early this year, the National Labor Relations Board found that Walmart illegally fired, disciplined, or threatened at least 60 employees for complaining publicly about wages.

“The Walmart economy—a business model where a few profit significantly on the backs of the working poor and a diminishing middle class—perpetuates the income inequality problems that are devastating our country,” OUR Walmart and the United Food and Commercial Workers union said in a statement Monday.

The unemployment rates from August to September went down about a full percentage point for African-American women (down from 10.6 to 9.6 percent), Hispanic women (down from 8.1 to 7.2 percent) and Hispanic men (down from 5.9 to 4.8 percent), and single mothers (down from 9.3 to 8.3 percent).

UPDATE, November 21, 2:31 p.m.: On Tuesday, the San Francisco Board of Supervisors passed a set of policies aimed at giving hourly workers more predictable schedules. Scheduled to go into effect in six months, the legislation will help ensure “more men and women in our community have schedules and hours that allow them pay their bills, plan their lives and take care of their loved ones,” said Gordon Mar, executive director of Jobs With Justice San Francisco, in a statement.

At 6 a.m. Thanksgiving Day, Christina of Long Island, New York, will be wide awake under the fluorescent lights of her local Old Navy for a six-hour shift, setting up signage for sales and new merchandise for the store to open at 4 p.m. that afternoon. The store will remain open for another straight 31 hours, with staff cleaning up past midnight.

Christina, 25, who declined to share her last name for fear of being fired, will also work another shift on Black Friday, but she’s not sure when she’ll be called in. “I have to be available to work even from midnight to 6 a.m.,” she said. “It frustrates me.”

Retail industry analysts expects this year’s holiday shopping season to be a boon, and to accommodate it, more major stores this year plan to open on Thanksgiving Day itself to cash in early on Black Friday sales. Stores also announced plans to hire thousands of seasonal workers across the country: Target planned to hire 70,000 workers, Kohl’s to hire 67,000, and Wal-Mart 60,000. About 43 percent of retail employers expect to hire these part-time workers, according to a Harris Poll survey of more than 2,000 companies nationwide.

But while holiday rush store openings and hiring represents a rosy outlook to sales this season, they exacerbate not so rosy conditions facing the majority of the nation’s 7.8 million retail sales workers and cashiers year-round: nearly 24-hour “on-call” demand from employers, reduced hours with only a couple hours notice (even after arriving to work), and fluctuating set schedules worked per week. Workers who complain or ask for specific hours never get called in, said Christina, who has also worked for Gap and Kohl’s.

Extreme holiday hiring is the next step, said Chris Tilly, director of UCLA’s Institute for Research on Labor and Employment who has studied retail labor for more than 20 years. “In the United States, it’s been a slippery slope from expanding part-time work to having unpredictable scheduling, to now, if we can an edge by selling on Christmas, we’ll do that,” told RHReality Check in a phone interview. “It’s uncivilized.”

Part-time retail workers today face these scheduling practices, especially workers in major clothing, grocery, and big-box stores like Wal-Mart and Target. Women workers, who make up about 55 percent of the retail sales workforce, are particularly hit by these scheduling practices, as these practices make it impossible for them to arrange child care or elder care, attend school or work another part-time job, all of which likely required them to seek a retail job in the first place. One in every ten working poor women work in retail, or about 1.3 million, a number expected to increase if retail work conditions do not change. Only 17 percent of retail workers in New York City have a weekly set schedule, and about a third knew their schedule one week in advance.

“You don’t know how when you’re going to work, how many hours you’re going to work, and how much money you’ll earn,” said Susan Lambert, associate professor at the University of Chicago School of Social Administration who studies low-wage work. “It creates high levels of instability and makes it very difficult to do anything else in your life.”

While working at Gap, Christina said, some days she’d be called in, and other days she’d wait for a call that never came. At Old Navy, she learns her upcoming week’s work schedule with only two days’ notice, which she says is not enough time to schedule other jobs or, say, doctor’s appointments. “Some days I’ll open, some days I’ll close. I don’t know which days I will work.”

Many workers also do not receive “reporting pay” when they arrive to work and are told to go home if they are not needed. This results in wasted money for transportation, child care, or turning down another job, Lambert said.

Christina remembers trekking for nearly two hours through a snowstorm one afternoon from her home in Queens to report to a four-hour shift at a Manhattan Gap store. “I clocked in, I’m working for half an hour, and my manager tells me, ‘we don’t need you today, you can go home,’” Christina said. “It felt like they didn’t have respect for my time. I could’ve planned my day to other things. That’s money that’s spent, time wasted.”

Why such scheduling? Employers compensate for flagging sales or meet profit goals by cutting hours as needed, minute by minute, depending on consumer traffic, sales predictions, even the weather, Tilly said. Stores now closely monitor these conditions through certain software.

Retailers also must meet certain profit quotas set by corporate leaders, and if store managers recognize they are not hitting those quotas, they’ll begin cutting hours. Holiday workers are often “hired” but may never be called in once if sales do not meet expectations, Lambert said.

A generation ago, retail work served as lifelong career. Retail workers kept regular hours and earned enough to pay a mortgage and feed their families. They rose through ranks to managerial and even ownership positions. Through the 1970s and ‘80s, retail stores faced increased competition from new big-box megastores like Wal-Mart, and took advantage of widespread unemployment to hire workers at low wages, to cut hours, and to encourage turnover, Tilly said. People today are desperate for jobs, and retail jobs are often the only jobs they can find.

“It’s not, I want to do the job, I need to do the job,” said Christina, who has been applying for other work. “I know a lot of people who think they would be unemployed if not for this job.”

Retail and wholesale employers have cut one million full-time jobs since 2006 and have hired back half as many part-time employees, according to the Bureau of Labor Statistics. Today, 41 percent of retail workers work part-time and earn 35 percent less than full-time employees. These workers are overwhelming women, and more than 70 percent are 25 years old or older. Retail workers are an expense, not an asset for investment, Lambert said, and therefore cut as much as possible.

Most of these practices have been completely legal—employers can lawfully change an employee’s work hours without any notice or without asking the employee’s consent, and in most states, employers do not have to pay employees who report to work but are sent home upon arrival. Employers are not legally required to provide any benefits—such as health coverage, paid time off, or workers’ compensation—to part-time workers.

Congress is considering the Schedules That Work Act, which would create a right for all employees to make scheduling requests and require employers to consider them and grant them, if reasonable. This bill would also require employers to pay employees reporting time pay, split shift pay, and two weeks’ notice of work schedules.

Such laws would create much needed fair standards in retail work, Lambert said, much like standards on child labor, overtime work, and weekend shifts. These standards will encourage workers to stay in their jobs and become better-trained, more reliable, and financially secure. Retail workers deserve set schedules, shift change, and reporting pay, Christina said, because the work is just as vital to the business.

“We all play a part in the company,” Christina said. “If you treat me well, the way we should be treated, I’m going to be a happy worker and we’ll have happier customers.”

A new report from Choices in Childbirth adds to a body of evidence that doula care should be included in health plans and made available to all women, particularly women of color, who face disproportionate rates of maternal and infant mortality in the United States.

This piece is published in collaboration with Echoing Ida, a Forward Together project.

While the Affordable Care Act has significantly improved access to health insurance and preventive care, some important types of care for pregnant women were left out of the health-care reform law, namely doula care.

A new report from Choices in Childbirth, a New York City-based health nonprofit, shows that doulas not only improve maternal health outcomes, but the maternal care and support they provide also empowers women to overcome discrimination in the health-care system, ultimately improving health outcomes.

The report highlights how doulas can help reduce health disparities—one of the key goals of the health-care reform law—by supporting positive outcomes. Doula care contributes to a reduction in medical interventions like cesarean sections, which can put women at additional risk for complications associated with a surgical procedure. Most births are low-risk and will progress naturally without surgery or intervention. By encouraging and allowing time and space for the body to do what it was designed to do, doula care also reduces the need for forceps and vacuum births, lessens the need for anesthesia, and is associated with positive outcomes like better newborn health indicators. Additionally, doula care is good for mothers during and after labor. Mothers assisted by doulas report having more positive feelings about their birth, and 80 percent said they felt more empowered.

In communities of color, where discrimination and disempowerment in the health-care system is prevalent, doula care can make a big impact. As Samantha Griffin, a doula with Mamatoto Village in Washington, D.C., explained to RH Reality Check via email, “There are so many things designed to take our power away in these situations: historical power dynamics, the way the health-care system is set up, the unknowns we have around our bodies and birth in particular. And then you have the vulnerability of labor and birth.”

This disenfranchising power dynamic is apparent in previouslypublishedstories—shared in various reports over the past few years—of Black women in labor being ignored, having their desires disregarded, and left without adequate information about their health status or health care. For example, the Reproductive Injustice report, published by the SisterSong Women of Color Reproductive Justice Collective, the National Latina Institute for Reproductive Health, and the Center for Reproductive Rights, explains how when one woman, Tiffany, “went into labor with her third child, she was forced to wait in the hallway of the public hospital in Jackson [Mississippi] because there were no available beds.”

[Tiffany explained:] “Not only was [the delivery ward] in the basement, women were lined up on the wall, in the hallway, in labor, I mean full out labor in the hallway.” … Despite her sister’s pleas for the nurses’ attention, Tiffany was ignored until the baby started to crown. Even then, the nurses told her, “Hold her. Don’t push.”

Deadly Deliverydescribes the consequences when women don’t receive the care they need:

“She was talked down to, things were not explained. She told me she was stunned by the way she was treated … She had to struggle to get the information she needed.” The woman eventually lost her baby.

These anecdotes are supported by data showing that Black women and other women of color are more likely to experience racial discrimination and receive lower quality care within the health-care system. But doula care can help shift power during labor and childbirth by providing mothers with information, tools, and confidence to speak up and advocate for the care, time, or attention they need. Griffin added, “I think that for many of the first time mothers, and women of color generally, my presence empowers them to ask questions of their providers and get information they may not get otherwise.”

Chanel Porchia, founder and executive director of Ancient Song Doula Services in New York City, further explained: “I don’t think doulas empower women as much as a woman empowers herself when she realizes her voice is being heard and she can make a decision [about how she wants to give birth] based in knowledge rather than fear.”

With doula assistance, women are empowered to be proactive in realizing their reproductive, health-care, and birth goals. Effectively, doulas are helping to achieve reproductive justice.

The report goes on to share that despite these proven benefits, only one-third of privately insured women knows about doula care, and only 6 percent of expectant mothers in the United States have benefited from doula care. Data from a survey of 2,400 women shows that 39 percent of the more than 300 Black women surveyed would have liked to have doula care, the highest proportion of respondents in the study.

But even if women do know about and seek doula care, they still may not be able to afford it. Nan Strauss, director of policy and research at Choices in Childbirth, told RH Reality Check in a phone interview, “The biggest barrier that prevents women from using doulas is cost. It’s great if you can afford to pay for it out of pocket, but even for middle income families, childbirth is one of most expensive health events in a family’s life.”

The average cost of doula care in New York City is $1,200—an expense that can be prohibitive when families may be paying for prenatal care and preparing their home for a new arrival on top of their usual expenses.

“Given the challenges with reimbursement, it’s hard to expand access to doulas because it means a real out-of-pocket expenditure for a lot of women. I think the biggest thing we could do is to make it affordable by making it reimbursable,” added Strauss.

Doula care is not typically reimbursed under Medicaid, but there is opportunity within Obamacare to change that. In 2013, the Centers for Medicare and Medicaid Services (CMS) issued a ruling allowing states to reimburse for preventive services that have been recommended by a licensed medical provider but that may be provided by a variety of professionals, including doulas. So far, two states—Oregon and Minnesota—have taken steps to reimburse doula care under Medicaid. All states should do the same.

“Our policy is to never turn anyone away,” said Chanel Porchia, “but the reality is that by opening the door to Medicaid coverage of doula care, more families would be able to get assistance.”

State leaders must take the opportunity to expand Medicaid under Obamacare so more women can have access to the essential preventive care doulas provide. Sadly, some of the states where politicians refuse to consider Medicaid expansion are the states that need it most. For example, Georgia has the second highest maternal mortality rate in the country, but instead of working to expand access to care, politicians have actively worked against it.

While improving insurance coverage for doula care could go a long way, it’s also important for organizations advocating for doula care expansion to provide communities with the resources they need to take their health into their own hands. “It will have to be for us by us,” explained Samantha Griffin, noting that Black women are the key to increasing the use of doula care in the Black community. “We have to make sure that regardless of age, income, education, sexuality, we all get access. The health of Black mothers and babies is too important to leave to chance.”

A new Economic Policy Institute report and "Fight for 15" protests have a common theme: Because employers pay their workers too little to live on, workers have to rely on government assistance to get by and taxpayers foot the bill.

Raising the minimum wage to $10.10 per hour would save millions in spending on public assistance programs, according to a report released Thursday.

The report was unveiled just as low-wage Walmart workers and activists with the “Fight for 15” movement took the streets in New York City and Washington, D.C. to protest poverty wages and demand a raise to a living wage of $15 per hour.

The report and the protests had a common theme: Bosses aren’t paying their fair share, leaving full-time workers to rely on government assistance to get by, and taxpayers foot the bill.

The report from the Economic Policy Institute finds that because businesses today are effectively paying workers 25 percent less than they did in the 1960s, government has had to take up the slack to help reduce poverty, effectively shifting a financial burden from the private sector to the taxpaying public.

A raise in the minimum wage to $10.10 per hour, as has been proposed by Congressional Democrats but blocked by Republicans, would allow nearly 2 million people to get off of public assistance and save $7.6 billion annually, according to the report.

The current federal minimum wage is $7.25 an hour. It hasn’t kept up with inflation, which makes the dollar worth less over time, but more importantly it hasn’t kept up with average wages or rising productivity.

If the minimum wage had grown as much as the average wage, it would be $10.89 by now, slightly more than Democrats and the EPI report authors are currently pushing for.

If it had grown as much as productivity, or how much we can produce on average from an hour’s worth of work, the minimum wage would be more than $18 per hour, well above what “Fight For 15” activists are pushing for.

The report’s author, David Cooper, told reporters on Thursday that the $7.6 billion savings figure is actually a conservative estimate.

Cooper told RH Reality Check that this report doesn’t look into exactly how much more money workers would have in their pockets overall, given that they would get less money in public assistance benefits as their wages rise.

But since public assistance programs are designed to gradually phase out as workers earn more, workers would still experience a net gain if they saw a raise resulting from an increased minimum wage.

One-fifth of workers would get a raise if the minimum wage were lifted to $10.10 per hour, the report says. About half of all public assistance dollars go to workers who currently make less than $10.10, and about half of workers who make less than $10.10 receive some public assistance. Every dollar in rising wages means 24 cents of savings in safety net spending, according to the report.

The $7.6 billion in savings on public assistance programs could go to federal expenditures like the Earned Income Tax Credit for childless adults or to creating jobs and improving infrastructure by building and improving roads, bridges, and schools, Cooper said.

“The bottom line is, that’s money that has been acting as a subsidy to low-wage employers who arguably haven’t been doing their fair share in the social contract—the understanding that in American society, if you work hard, you should be paid enough to make ends meet,” Cooper said.

The unemployment rate in September was the lowest it has been in six years, according to new data from the Bureau of Labor Statistics, but wages still aren’t going up and some vulnerable populations still have high unemployment rates.

The unemployment rate in September was the lowest it has been in six years, according to new data from the Bureau of Labor Statistics, but wages aren’t rising and some vulnerable populations still have high unemployment rates.

The September jobs report looks like very good news overall. The jobless rate fell below 6 percent for the first time since the recession that began in 2008. The economy added 248,000 jobs, more than the 215,000 jobs economists had expected, and it turns out that August’s disappointing numbers were better than previously thought.

Policy analysts say that while the report shows improvement, there are still areas of concern.

One worrisome number is the labor force participation rate, which is the lowest it’s been since 1978. The official unemployment rate only includes people who are out of work but are actively looking for a new job, but the labor force participation rate includes people who might want a job but have given up looking for one.

An Economic Policy Institute analysis estimates that if these “missing workers” were included, the unemployment rate would actually be about 9.6 percent. We haven’t seen an official unemployment rate that high since August 2009, when the country was just starting to emerge from a catastrophic recession.

And even the official unemployment rates remain much too high for both men and women of color, Kate Gallagher-Robbins, senior policy analyst at the National Women’s Law Center, told RH Reality Check.

The unemployment rates from August to September went down about a full percentage point for African-American women (down from 10.6 to 9.6 percent), Hispanic women (down from 8.1 to 7.2 percent) and Hispanic men (down from 5.9 to 4.8 percent), and single mothers (down from 9.3 to 8.3 percent).

While that’s good news, most of those unemployment rates are still much higher than for the population at large, and even as high as the overall rate during the height of the recession.

“I do worry that as the economy overall recovers, that some policymakers will become complacent and ignore that certain groups are still at what we consider crisis levels,” Gallagher-Robbins said.

The Obama administration and Democrats acknowledged that while the jobs report was good, more needs to be done.

“Even as we take stock of the progress that has been made, too many Americans do not yet feel enough of the benefits,” said Jason Furman, chairman of the White House Council of Economic Advisers, said in a statement, pointing to President Obama’s recent remarks at Northwestern University on how to get the economy moving again.

Senate Majority Leader Harry Reid (D-NV) issued a statement praising the jobs numbers but condemning Republicans in Congress for obstructing policies that would further help middle-class families, and the statement on the jobs report by House Speaker John Boehner (R-OH) touted Republican economic policies while not actually mentioning the jobs report.

Another problem is that wages are still stagnant. They didn’t grow at all from August to September, and wage growth over the last year is much lower than it should be.

This is partly because while jobs have been steadily added since the recession, most of those jobs are low-wage and not as secure as the kinds of jobs that were lost. This month, a quarter of job gains were in typically low-wage industries like retail and hospitality.

In a sense, people haven’t regained jobs lost in the recession, but rather traded them for worse ones. And given that women make up about two-thirds of low-wage workers, this hits them especially hard.

“In our work, we hear from people anecdotally that the jobs they’re looking for are just not available,” Gallagher-Robbins said. “And when jobs are available, they often pay low wages and have very difficult schedules for women trying to balance jobs with child care or school.”

Men gained more jobs than women this month, and their unemployment rate has gone down more sharply in the past year—from 7 to 5.3 percent for men and from 6.2 to 5.5 percent for women. That’s to be expected, Gallagher-Robbins said, since men lost more jobs during the recession. Indeed, she said, this month could mark the end of what people have been calling the “mancession.”

Still, more job gains in low-wage industries went to women than men. And that’s just looking at industry overall, not particular jobs; more women end up with the lower-paying jobs in those lower-paying industries.

Women were also hit harder than men by cuts to public-sector jobs. Those cuts, largely the product of adherence to austerity in the wake of 2008’s economic collapse, are one reason this recovery is taking longer than usual.

Both women and men have seen growth in low-wage jobs over the past few years, Gallagher-Robbins said, and a strong recovery will require more and better jobs for both men and women. That means policy choices like raising the minimum wage so that low-wage jobs hurt people’s pocketbooks less, giving low-wage workers more predictable schedules, and providing paid family leave so that low-wage workers can care for their families.

This month’s job report shows that the labor market is “better than it was, but there’s still a long way to go,” Gallagher-Robbins said. “It’s not good for men or women.”